In August the U.S. Food and Drug Administration (FDA) called for stronger warning labels for stimulant drugs used to treat attention deficit disorder (ADD). The biggest change applies to amphetamine-containing drugs for attention deficit hyperactivity disorder (ADHD)-Adderall and Dexedrine-as well as methylphenidates like Concerta and Ritalin.
Dangerous Drugs?
Although the "black box" warning on these drugs is the strongest the FDA can request, many experts say it's not strong enough. Stating that "misuse of amphetamines may cause sudden death and serious cardiovascular adverse effects" is misleading, says Sidney M. Wolfe, MD, at the Health Research Group, since it fails to tell patients that they may suffer sudden death if they use these meds properly but have certain heart conditions.
Despite these concerns, the first long-term study of preschoolers taking Ritalin found benefits, even though it also warned of side effects ranging from slowed growth to irritability and insomnia in 40 percent of young children participating. "This is a catastrophe," says Peter Breggin, MD, a New York psychiatrist who opposes the use of psychiatric drugs in children.
In addition to thorough physical assessments for heart disease, Dr. Wolfe advises monitoring anyone taking these stimulants for aggressive or hostile behavior. Other concerns include seizures and vision problems. Youngsters taking these drugs are also more likely to smoke, research finds, while Ritalin and amphetamines are commonly abused drugs.
The Root of the Problem
Attention problems have been linked to everything from artificial additives/colors/preservatives, an infant's not crawling enough, heavy metal and pesticide exposure, maternal alcohol use and smoking, food allergies, celiac disease, and genes. However, "parents and teachers today seem to believe that any boy who wriggles in his seat and willfully defies his teacher's rules has ADHD," says Elizabeth J. Roberts, MD, a California child psychiatrist.
"Well-intentioned but misinformed teachers, parents using the Internet to diagnose their children, and hurried doctors are all part of a complex system that drives the current practice of misdiagnosing and overmedicating children. The solution lies in the practice of good, conscientious medicine that is careful, thorough, and patient-centered," she adds.
Nutrition Counts
Fortunately, as one recent study suggests, "food supplement treatment of ADHD may be of equal efficacy to Ritalin treatment." All children (but especially those with learning difficulties) benefit from a vitamin-mineral multiple with antioxidants, B complex, and vitamin C. Essential amino acids that support production of neurotransmitters necessary for optimal brain function and essential fatty acids that promote brain development and reduce aggressive/impulsive behavior are useful supplements to consider.
Nutritionist Marcia Zimmerman, MEd, CN, recommends eliminating common allergenic foods (dairy, wheat) for a month, then slowly adding back nutritious choices. She also advises cutting out additives blacklisted on the Feingold program: artificial colorings, flavorings, sweeteners, preservatives, and salicylates (in aspirin and many foods, including apples, oranges, and plums).
Since protein foods (eggs, fish, lamb, legumes, skinless poultry, and tofu) support alertness and concentration, serve them for breakfast and lunch, leaving more relaxing carbohydrates (particularly favorite fruits and vegetables) for dinner and/or an evening snack. Because certified organic foods are produced without persistent, toxic chemicals, they're positive choices for anyone with attention problems.
Other Alternatives
Creative educational techniques-brief lessons with the child as an active participant and hands-on direct instruction from computer-based software-are important to school success. For young children, Montessori teaching methods with their physical, sensory, individualized approach to learning can be especially beneficial.
Most ADD/ADHD children thrive outdoors, so make hiking, nature study, skating, skiing, swimming, and other noncompetitive activities part of your family routine. Biofeedback, massage, and yoga are other alternatives that may help these children at different ages and developmental stages.
Finally, focus on the positive side of your ADD/ADHD child's behavior: Channel his energy in constructive ways, "catch" her doing something right and praise her, or make use of his creativity. Parents of children with attention deficits also need to face their own fears that they are somehow to blame for this disorder-and to give themselves credit for all they do to set clear guidelines, reinforce responsible behavior, foster self-esteem, and encourage persistent effort by their child.
Selected Sources
The ADD Nutrition Solution by Marcia Zimmerman, MEd, CN ($15, Owl, 1999) "ADHD and Drug Therapy: Is it Still a Valid Treatment?" by A. M. Doggett, J Child Health Care, 3/04 "Essential Fatty Acids and Their Role in Conditions Characterized by Impulsivity" by M. R. Garland and B. Hallahan, Int Rev Psychiatry, 4/06 "FDA Issues Stronger Warnings for ADHD Stimulants; Warnings Don't Go Far Enough," Worst Pills/Best Pills News, 11/06 The Feingold Association, www.feingold.org The Gift of ADHD by Lara Honos-Webb, PhD ($14.95, New Harbinger, 2005) "Methylphenidate Increases Cigarette Smoking" by C. R. Rush et al., Psychopharmacology, 10/05 "Nutrition in the Treatment of Attention-Deficit Hyperactivity Disorder: A Neglected but Important Aspect" by R. Schnoll et al., Appl Pyschophysiol Biofeedback, 3/03 "Omega-3 Fatty Acid Deficiencies in Neurodevelopment, Aggression, and Autonomic Dysregulation: Opportunities for Intervention" by J. R. Hibbeln et al., Int Rev Psychiatry, 4/06 "Outcome-based Comparison of Ritalin versus Food-Supplement Treated Children with AD/HD" by K. L. Harding et al., Altern Med Rev, 8/03 "A Preliminary Investigation of ADHD Symptoms in Persons with Celiac Disease" by H. Niederhofer and K. Pittschieler, J Atten Disord, 11/06 "A Rush to Medicate Young Minds" by Elizabeth J. Roberts, Washington Post, 10/8/06"Study: Some Preschoolers Can Use Ritalin" by Lindsey Tanner, Seattle Post-Intelligencer, 10/19/06 "In Utero Exposure to Background Concentrations of DDT and Cognitive Functioning among Preschoolers" by Nuria Ribas-Fito et al., American Journal of Epidemiology, 9/12/06 Stopping ADHD by Nancy E. O'Dell, PhD, and Patricia A. Cook, PhD ($15.95, Penguin Group/Avery, 2004)
 | You may wonder what is the difference between ADD and ADHD? ADHD is a childhood condition that affects the brain's impulse control and forward planning ability. ADHD is treatable, but an evaluation is needed to rule out other potential causes. |
 | ADHD medications for children has traditionally been stimulants such as Ritalin. Doctors are now finding that some patients respond to non-stimulants, antidepressants and combinations of drug treatments and therapy. |
 | If you're interested in pursuing a drug-free ADHD therapy for your child, start with a psychologist who is known for treating disorders without using psychiatric drugs. |
Don't accept an ADHD diagnosis as a certainty, because the symptoms of ADHD could also indicate other conditions. |
If your child has had an ADHD diagnosis and is struggling in school, he might not be getting the treatment he needs. |
